在气管切开术的儿童中,与意外脱相关的因素
Gregory S Villarroel1, Macarena Faúndez2, Yorschua F Jalil3
1Hospital Josefina Martínez, Santiago, Chile; Carrera de Kinesiología, Facultad de Ciencias de la Salud, Universidad San Sebastián, Sede Santiago, Chile; and Blanquerna Universitat Ramon Llull, Facultat de Ciencies de la Salut, Programa de Doctorado Salud, Bienestar y Bioética, Barcelona, Catalunya, Spain. gregoryvs@blanquerna.url.edu.
Respiratory care
|August 23, 2023
概括
儿科气管切除术患者的意外脱管与坐姿,小管尺寸和护理人员减少有关. 这些因素增加了儿童患这种危险并发症的风险.
科学领域:
- 儿科重症监护医药 儿科重症监护医药
- 耳鼻喉科 耳鼻喉科 耳鼻喉科
- 呼吸系统疗法 呼吸系统疗法
背景情况:
- 气管切除术在儿科重症监护室患者中很常见,但存在风险.
- 意外脱 (AD) 是一个频繁且可能致命的并发症.
- 识别与AD相关的因素对于患者安全至关重要.
研究的目的:
- 为了确定与小儿气管切除术患者意外脱管相关的因素.
- 在需要长时间机械通风的儿童中识别AD的风险因素.
- 在这个脆弱人群中为预防AD策略提供信息.
主要方法:
- 在2013-2018年期间进行了一项病例控制研究.
- 病例是患有意外脱的儿科患者;对照组是没有AD的患者.
- 使用1:2分配比,将病例与来自同一医院的人群的对照进行匹配.
主要成果:
- 在140名住院的儿科患者中,41人发生了意外的脱.
- 坐着可以达到中线的儿童患阿兹海默症的风险明显高 (OR 9.5).
- 更小的气管切口管内径 (≤4.0毫米) (OR5.18) 和较低的护士与患者比率 (OR4.48) 也与AD风险增加有关.
结论:
- 儿科气管切除术患者意外脱管的关键风险因素包括坐着的能力,较小的管子尺寸和减少的护理监督.
- 这些发现凸显了加强监测和定制干预措施的必要性.
- 预防策略应考虑患者的位置,气管切除管的选择和人员配置水平.
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